Nursing Elites

1. A client with obsessive-compulsive disorder (OCD) tells the nurse, 'I know my behavior is unreasonable, but I can't help it.' What response should the nurse provide?

• A. Your behavior is part of your illness, and it is important to work on changing it.
• B. It is important to understand why you feel the need to perform these behaviors.
• C. Let's figure out a way for you to control these behaviors.
• D. It sounds like you are feeling powerless to change your behavior.

Correct answer: D

Rationale: The nurse should acknowledge the client's awareness of the irrationality of their behavior and the feeling of powerlessness to change it. By reflecting the client's feelings, the nurse validates them and opens a discussion on strategies to manage the behavior effectively. Empathy and understanding are key in supporting clients with OCD. Choice A is incorrect because it focuses more on changing the behavior rather than acknowledging the client's feelings. Choice B is incorrect as it does not directly address the client's sense of powerlessness. Choice C is incorrect as it doesn't validate the client's feelings of being unable to control the behaviors.

2. Which response demonstrates accurate information that should be discussed with the female patient diagnosed with bipolar disorder and her support system? Select the incorrect one.

• A. Remember that alcohol and caffeine can trigger a relapse of your symptoms.
• B. Due to the risk of a manic episode, antidepressant therapy is never used with bipolar disorder.
• C. It's critical to inform your healthcare provider immediately if you are experiencing sleep disturbances.
• D. Is your family prepared to be actively involved in helping manage this disorder?

Correct answer: B

Rationale: In managing bipolar disorder, it is vital to educate the patient and their support system about triggers like alcohol and caffeine, the significance of good sleep, and the need for family involvement. However, the statement in choice B is incorrect. While antidepressants need to be carefully monitored in bipolar disorder, they can be used in conjunction with mood stabilizers to manage depression in some cases.

3. A client with bipolar disorder is experiencing a depressive episode. Which of the following interventions should the nurse implement? Select one that does not apply.

• A. Encourage participation in activities
• B. Promote adequate nutrition and hydration
• C. Monitor for suicidal ideation
• D. Discourage verbalization of feelings

Correct answer: D

Rationale: Interventions for a client with bipolar disorder experiencing a depressive episode include encouraging participation in activities, promoting adequate nutrition and hydration, monitoring for suicidal ideation, and providing a structured daily schedule. Discussing feelings is an essential part of therapy for clients with bipolar disorder, thus discouraging verbalization of feelings is not therapeutic and should not be implemented. Choice D is incorrect because it goes against the principles of therapeutic communication and emotional expression, which are crucial in managing bipolar disorder.

4. When assessing a client with suspected bipolar disorder, which of the following findings should the nurse not expect?

• A. Periods of elevated mood
• B. Decreased need for sleep
• C. Flight of ideas
• D. Anhedonia

Correct answer: D

Rationale: In bipolar disorder, common findings include periods of elevated mood, decreased need for sleep, and flight of ideas. Anhedonia, the inability to feel pleasure, is more indicative of conditions like major depressive disorder. Therefore, the nurse should not expect to find anhedonia in a client with suspected bipolar disorder.

5. A healthcare professional is assessing a client's use of defense mechanisms. Which statement would indicate to the healthcare professional that the client is using the defense mechanism of projection?

• A. The client accuses others of being angry when it is the client who is angry.
• B. The client refuses to acknowledge a problem despite evidence to the contrary.
• C. The client attributes his own feelings of hostility to others.
• D. The client avoids dealing with painful feelings by focusing on something else.

Correct answer: C

Rationale: Projection is a defense mechanism where individuals attribute their own unacceptable feelings, thoughts, or impulses onto others. In this case, the client is projecting his own feelings of hostility onto others by assuming they possess these feelings instead.

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